Does Finasteride Work For Women
Right now, finasteride is only approved by the FDA for use in men. However, over the last few decades, several studies have investigated it as a potential treatment for hair loss in women.
One of the first large-scale studies of finasteride for women was published in 2000, in the Journal of the American Academy of Dermatology.
A team of researchers assessed the effects of finasteride in 137 postmenopausal women with female pattern hair loss.
The women took 1mg of finasteride per day for a total period of one year.
At the end of the study period, the researchers concluded that finasteride didnt have any real effect on hair growth, nor did it appear to prevent hair thinning.
In 2006, a study published in the journal Archives of Dermatology also looked at the effects of finasteride in women.
This time, the women received finasteride at a stronger 2.5mg dosage. They also used an oral contraceptive containing the hormones drospirenone and ethinyl estradiol, which are common active ingredients in birth control pills.
After 12 months, the researchers were able to record a statistically significant improvement in the womens average hair density.
However, its worth noting that its unclear whether the improvement could be attributed to the finasteride or to the oral contraceptive.
In a more recent study from 2013, researchers also found that finasteride appeared to help with female hair loss.
How Does Finasteride Affect The Body’s Hormonal/endocrine System
Finasteride is a specific type II 5-alpha reductase inhibitor. That is, it inhibits the enzyme responsible for regulating the conversion of testosterone to dihydrotestosterone . By reducing DHT levels in the scalp, the drug decreases DHT’s effects on the hair follicles, reversing the process of hair loss.
How Long Does Finasteride Take To Work
Everybody is different, and how long it takes for Finasteride to work depends on your particular level of baldness. However, if you take your medication exactly as prescribed, generally you will start to see results by month three or four. It can take up to a year to see maximum results. Itâs important to note that Finasteride, Propecia and Proscar will not always cause you to regrow hairs that youâve previously lost rather, it will help stop further hair loss and help you maintain your current length. Thatâs why Finasteride is often prescribed alongside Minoxidil, a medication that helps promote hair growth, thickness and strength.âFinasteride will stop working when you stop taking it, so itâs important to keep taking it for as long as you want to stop hair loss. If you stop taking Finasteride daily, you will lose the hair youâve gained in about a year.
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Does Finasteride Cause Any Side Effects
In clinical trials, finasteride was very well tolerated in men, with most patients reporting no serious side effects. The principal side effects associated with finasteride were decreased libido and erectile dysfunction . In addition, decreased volume of ejaculate was reported in 0.8% of men treated with finasteride and 0.4% of those on placebo. Gynaecomastia has also been reported. All of these side effects resolved upon discontinuation of therapy, and also resolved in many men who preferred to continue therapy. Postmarketing reports have included some patients complaining of depression, but the risk of this is likely very small.
Interactions With Other Medications
An interaction is when a substances changes the way a drug is intended to work. It can be harmful or prevent the drug from working at all. To help prevent interactions, it is best to speak with your doctor prior to taking any medications, vitamins or herbs.
To find out how finasteride oral tablet might interact with something you are currently taking, tal to your doctor of pharmacist.
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Propecia For Hair Loss The Basics
What is Propecia?
Propecia, along with its generic equivalent finasteride, is the only medication available that effectively targets the root cause of male pattern baldness, a hormone called DHT.
It was originally formulated as a treatment for BPH . Researchers noticed that patients on the drug also regrew hair Propecia was officially approved by the FDA as a hair loss treatment in 1997.
Finasteride before and after photos from a Japanese study. The bottom photo was taken 10 years after the first one!
How it Works
Propecia blocks the conversion of testosterone to DHT. It reduces DHT levels in the body by about 70% and can dramatically slow, stop, and even partially reverse hair loss in some men. DHT is essential to male development during puberty, but its generally thought not to yield many tangible benefits after puberty. Some disagree, of course. More on that later.
Who Its For
Propecia is FDA-approved to treat hair loss in men only, though it is sometimes prescribed to women for off-label use. See my article on female hair loss for more info.
When Hair May Regrow On Its Own
Yes, your hair may regrow on its own. This can happen if you recently:
Had a baby
Recovered from a major illness or had surgery
Underwent cancer treatment
Lost 20 pounds or more
Developed a mild case of a disease called alopecia areata, which causes your immune system to attack your hair follicles
Got rid of psoriasis on your scalp
Your dermatologist can tell you whether your hair may start to grow again on its own.
Sometimes to see regrowth, you need to make some changes.
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Finasteride For Women: The Scientific Evidence
Since 1997, finasteride has been used exclusively in men for the treatment of AGA. However, the drug has yet to be approved for use by women who are suffering from the same condition.
The main reason for this is that finasteride is classified as a Category X drug which means it has high potential to cause serious harm to fetuses. As such, use in women of child-bearing age is extremely risky, and the benefits dont outweigh the negatives.
While studies have been performed on the use of finasteride in pre-menopausal women, the caveat is that these women were also on an oral contraceptive . Therefore, there is no way to prove that finasteride alone was responsible for the results seen.
But those arent the only studies to have been performed.
Studies performed on postmenopausal women are also available for review, and these offer a more in-depth look at the effects of finasteride on female-pattern alopecia.
Patterns Of Female Hair Loss
Clinicians use the Ludwig Classification to describe female pattern hair loss. Type I is minimal thinning that can be camouflaged with hair styling techniques. Type II is characterized by decreased volume and noticeable widening of the mid-line part. Type III describes diffuse thinning, with a see-through appearance on the top of the scalp.
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Where To Buy Hair Loss Medication
The most accessible hair loss treatments are those made with minoxidil. Brands like Rogaine are widely available over the counter at pharmacies and online retailers.
Prescription drugs used to treat hair loss finasteride, spironolactone, and dutasteride are more accessible with subscription-based telehealth platforms like Hims, Keeps, and Roman.
Hims is a telemedicine company that offers treatments for a variety of health conditions, including hair loss for men.
Over-the-counter products, such as minoxidil foams and solutions, are available for anyone to purchase.
If youre interested in prescription-strength products, such as oral finasteride, Hims can connect you with a healthcare professional from your own home.
The cost of Hims varies considerably. A 3-month supply of some of their most popular hair loss products is priced at $195.
How Does Finasteride Work
The key to Mercks success with finasteride lies in the drugs ability to reduce a very specific enzyme called 5-alpha-reductase. This is important because 5-alpha-reductase is what creates the byproduct of testosterone believed to be the main culprit behind male pattern baldness: dihydrotestosterone .
While some hair loss is caused by hormone imbalances, illness or stress, male pattern baldness is caused by hair follicles that are sensitive to DHT. DHT causes hair follicles to shrink over time, and as they shrink, they produce fewer hairs.
As the follicles shrink, the hairs they produce may change in texture and thickness, and theyll eventually stop producing hairs altogether. And because the follicles on the top and crown of the head tend to contain DHT-sensitive follicles, we often see male pattern baldness begin with a receding hairline on the forehead or thinning hair at the crown .
In later stages of male pattern baldness, men are typically left with a horseshoe pattern, with remaining hair only on the sides and back of the head although some men also experience thinning hair in those areas as well.
But by reducing the 5-alpha-reductase enzyme, Propecia reduces the prevalence of DHT, which means the drug is essentially eliminating the cause of hair loss in the first place .
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Hair Loss: Diagnosis And Treatment
Dermatologist examining a patient with hair loss
To find out what’s causing your hair loss, a dermatologist may use a tool called a dermascope to get a closer look.
Effective treatment for hair loss begins with finding the cause. To get an accurate diagnosis, it helps to see a board-certified dermatologist. These doctors have in-depth knowledge about the many causes of hair loss and experience treating the diverse causes.
How To Tell If The Drug Is Working
You may notice less hair loss and more hair growth on your head.
Important Considerations for Taking Finasteride
Keep these considerations in mind if your doctor prescribes you to start taking finasteride.GeneralDont crush, cut, or chew the tablets.
StorageStore at room temperature between 59°F and 86°F .Keep it away from light and high temperature.Dont store this medication in moist or damp areas, such as bathrooms.
RefillsYour doctor will write the number of refills authorized on your prescription.TravelWhen traveling with your medication:When flying, never put it into a checked bag. Keep it in your carry-on bag.Dont worry about airport x-ray machines. They cant harm your medication.Be prepared to show the pharmacy label to TSA for your medication. Always carry the original prescription-labeled container with you.Dont put this medication in your cars glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.Prior authorizationApproval is determined on a plan-by-plan basis.Are there any alternatives?There are other drugs available to treat your condition. Talk to your doctor about other drug options that may work for you.
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Medical Therapy For Female Pattern Hair Loss
Female pattern hair lossto treat or not to treat? And with what? Does anything really work for women?
Many in our field would argue that its not worth even treating women, citing concerns about donor area, the paucity of effective treatments, or how it can be difficult or impossible to achieve patient satisfaction. But these concerns should not prompt us to give up. Rather, women can be some of the most rewarding patients to treat, and using simple things like handouts, dermoscopy, and photography can help increase understanding, reduce confusion, increase compliance, and dramatically improve their response to treatment.
Women often undergo an extensive workup before arriving at a diagnosis of FPHL. They may start by seeing their internist, then their OB/GYN, then their endocrinologist, and even a naturopath before seeing a dermatologist or hair loss specialist. Along the way, they may get told that the hair loss is due to stress, adrenal fatigue, or low-normal thyroid function, all of which when corrected fails to stop the hair lossuntil they find YOU! In a matter of seconds, you recognize the presence of miniaturized hairs either on clinical examination or with the use of dermoscopy. Finally, they get the diagnosis they have been dreading: female pattern hair loss. They believe nothing can be done for themor can it?
Can You Combine Finasteride With Minoxidil
There are no human data supporting the use of the combination of finasteride and minoxidil. Scientific studies would be required to assess the safety and efficacy of such a combination.
However, the combination has been safely prescribed to many patients and has appeared useful. If switching from one treatment to the other, it is best to overlap by six months to reduce the chance of hair loss from the withdrawal of the first treatment while waiting for a response to the new product.
New Zealand approved datasheets are the official source of information for these prescription medicines, including approved uses and risk information. Check the individual New Zealand datasheet on the Medsafe website.
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Side Effects Of Finasteride
Like any medication, there are some side effects to be aware of when taking Finasteride. Tell your doctor if you experience any of these side effects.Side effects of Finasteride are rare, but can include: – Erectile dysfunction and lowered libido- Skin rash- Swelling or tenderness in breasts- Dizziness or lightheadedness- Chills or cold sweats- Depression- Lumps or pain in breasts- Nipple dischargeâSerious side effects are not common, but can occur. Swelling of lips, tongue, throat or face
What Treatments Dont Work Or Cost Too Much
There are countless men out there who are desperate to stop male pattern baldness, so theyll try just about everything they can.
Unfortunately, many of the hair loss treatments currently on the market either dont work, or are effective but prohibitively expensive. These include:
Laser combs and other products. Often referred to as low-level laser therapy , these products use laser light to stimulate the hair follicles. Research is mixed on their effectiveness and many devices of this type cost hundreds or thousands of dollars.
Hair oils. Several essential oils are marketed as treatments for pattern hair loss. While some have shown mild effects in small studies, none are as effective as FDA-approved hair loss treatments such as finasteride and minoxidil.
Corticosteroids. These medications are used to reduce inflammation, which can cause hair loss in certain situations. While they may be useful for some non-hormonal forms of hair loss, theres no evidence that they prevent or slow down pattern hair loss.
Topical corticosteroids. While these may be prescribed for certain inflammatory scalp conditions, theyre not used for male pattern baldness.
Hair transplant surgery. Although hair transplant surgery is effective, its an expensive option. The cost of a hair transplant can vary from a few thousand to tens of thousands of dollars, depending on the extent of your hair loss and number of grafts required.
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Procedures To Help Regrow Hair
While at-home treatments offer convenience, a procedure performed by a board-certified dermatologist tends to be more effective. For this reason, your dermatologist may include one of the following in your treatment plan.
Injections of corticosteroids: To help your hair regrow, your dermatologist injects this medication into the bald areas. These injections are usually given every 4 to 8 weeks as needed, so you will need to return to your dermatologists office for treatment.
This is considered the most effective treatment for people who have a few patches of alopecia areata, a condition that causes hair loss. In one study of 127 patients with patchy alopecia areata, more than 80% who were treated with these injections had at least half of their hair regrow within 12 weeks.
Hair transplant: If you have an area of thinning or balding due to male pattern baldness, your dermatologist may mention a hair transplant as an option. This can be an effective and permanent solution.
Laser therapy: If using minoxidil every day or taking medication to treat hair loss seems unappealing to you, laser therapy may be an option. Also called low-level laser therapy, a few studies suggest that this may help:
Hereditary hair loss
Hair loss due to chemotherapy
Stimulate healing and hair growth after a hair transplant
Studies indicate that laser therapy is safe and painless but requires many treatment sessions. To see a bit of hair growth, you may need several treatments a week for many months.